Early Menarche: Is it a Risk Factor for Depression, Substance Abuse, and Eating Disorders? Facilitator: Ann Hung, Mental Health Board Intern June 8th, 2011 Agenda 1. Early puberty 2. Biological, environmental, and nutritional aspects 3. Stress hypotheses 4. Negative psychosocial outcomes: Depression Substance Use Eating Pathology 5. Limitations of research and implications for clinical practice Puberty Are girls developing earlier than before? (Herman-Giddens et al., 1997; Walvoord, 2010) Pubarche, thelarche & menarche Ethnic differences in onset of puberty (Obeidallah et al., 2000; Chumlea et al., 2003) Biological and Environmental Antecedents Biological genes (Brooks-Gunn & Warren, 1988) Environmental poverty father absence (Surbey, 1990; Deardorff et al., 2011) family conflict Nutrition and Obesity (Kaplowitz et al., 2001; Davidson et al., 2003) Stress Hypotheses (Caspi & Moffitt, 1991) 1. Stressful Change 2. Off-time 3. Early-Timing Total Behavior Problem Score (RBPC) Caspi & Moffitt, 1991 Behavior Problems as a function of age at menarche 25 20 <12 12-13 13-14 14-15 15 10 5 0 13 Age 15 Depression Theoretical Underpinnings physical changes hormonal changes Comorbidity with other disorders (Patton et al., 1996; Hayward et al., 1996; Graber et al., 2004) Results among racial minorities (Hayward et al., 1999) (Ge et al., 2003) Eating Pathology Two central mechanisms (Stice & Shaw, 2002) dieting negative affect Mixed findings re. early menarche on eating pathology Other factors leading to eating disorders Precursors and Consequences of Body Dissatisfaction Substance Use Early maturers → increased risk of substance use (Dick et al., 2000) Association of girls with older peers (Magnusson et al., 1986; Moffitt et al., 2001) Means for self-medication Racial Differences cigarette use (Negriff et al., 2010) Limitations of Current Literature Lack of follow-up reports Retrospective data Measurement criterion Dearth of racially diverse samples Implications for Clinical Practice Spending more time on body dissatisfaction sociocultural ideals of thinness critical consumers of mass media Intervention programs targeted during the most developmentally challenging and stress inducing times Informational programs for parents 5th vital sign References Belsky, J., Steinberg, L., & Draper, P. 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